Key result
MAP below 65 mmHg in early cardiogenic shock linked to ~3.6-fold higher in-hospital mortality.
Why the study?
There was a scarcity of local evidence examining the association between mean arterial pressure and in-hospital mortality in cardiogenic shock patients.
Does low mean arterial pressure (<65 mmHg) in the first 24 hours increase in-hospital mortality in patients with cardiogenic shock?
Cohort (n=120)
No
Does low mean arterial pressure (<65 mmHg) in the first 24 hours increase in-hospital mortality in patients with cardiogenic shock?
Odds Ratio: 3.56 (95% CI 1.78–7.14)
p-value: p=0.001
A mean arterial pressure below 65 mmHg during the first 24 hours of cardiogenic shock is strongly associated with increased in-hospital mortality, underscoring the critical need for prompt hemodynamic optimization.
MAP <65 mmHg early in cardiogenic shock was associated with higher mortality; leaves open optimal targets pending randomized trials.
Cardiogenic shock remains a critical condition characterized by inadequate tissue perfusion and high mortality despite advancements in cardiac care. Mean arterial pressure (MAP) serves as a key hemodynamic parameter that reflects systemic perfusion and directly influences patient outcomes. Recognizing the scarcity of local evidence, this study aimed to examine the association between MAP and in-hospital mortality among cardiogenic shock patients admitted to the Cardiology Department of Ayub Teaching Hospital, Abbottabad. A retrospective observational design was employed, and data were collected from patient medical records, including demographic details, hemodynamic parameters, and clinical outcomes. Patients were categorized into three MAP groups: <65 mmHg, 65–75 mmHg, and >75 mmHg. Statistical analysis was conducted to compare mortality rates and evaluate the predictive relationship between MAP and survival outcomes. The results revealed that patients with a MAP below 65 mmHg during the first 24 hours of admission exhibited a significantly higher mortality rate compared to those within the optimal range of 65–75 mmHg. Excessively high MAP levels were also associated with adverse outcomes due to increased cardiac workload. The findings underscored the importance of maintaining individualized MAP targets to ensure adequate perfusion without overburdening the myocardium. Future research should focus on developing patient-specific MAP management protocols, integrating advanced monitoring technologies, and validating these findings through multicenter studies to improve cardiogenic shock outcomes globally.
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Dr. Arshad Ali (2025) conducted a cohort in Cardiogenic shock (n=120). Mean arterial pressure < 65 mmHg vs. Mean arterial pressure ≥ 65 mmHg was evaluated on In-hospital mortality (OR 3.56, 95% CI 1.78-7.14, p=0.001). Mean arterial pressure below 65 mmHg during the first 24 hours of cardiogenic shock independently increased the odds of in-hospital mortality by over three times (OR 3.56) compared to higher perfusion pressures.
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